Ppi Lembar Audit Fasilitas Alat Pelindung Diri.docx

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LEMBAR AUDIT FASILITAS ALAT PELINDUNG DIRI RSKGM FKG UI TANGGAL

: …………………….

UNIT

: …………………….

NO.

PERNYATAAN

1. 2.

Ada kebijakan alat pelindung diri Tersedia masker di ruang perawatan, intensif,tindakan sesuai dengan kebutuhan Tersedia sarung tangan on steril dan steril di ruang perawatan, ruang intensif dan ruang tindakan sesuai dengan kebutuhan Tersedia topi di ruang perawatan, ruang intensif dan ruang tindakan sesuai dengan kebutuhan Tersedia gaun di ruang tindakan sesuai dengan kebutuhan Tersedia sandal yang tertutup bagian depan di ruang tindakan

3.

4.

5. 6.

Skoring:

YA

TDK

KET.

x 100% = .......... % 6 Surveyor, ( …………………….. )

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